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CaribMedia Marketing & Consultancy N.V.
Ierlandstraat 11, Oranjestad, Aruba,
Dutch Caribbean.
Tel: (297) 583-4144 Fax: (297) 582-6102
Website: http://www.visitaruba.com/plus
Email: plus@visitaruba.com

2008 REGISTRATION FORM
VisitAruba Plus
Card membership

PLEASE PRINT OUT, FILL IN,
AND FAX TO (297) 582-6102


Last Name: __________________________  First Name(s):_____________________________

Mailing Address: ________________________________________________________________

City:  ________________________________                State: ____________________________

Zip/Postal Code:______________________                 Country:__________________________

Phone: ______________________________                 Fax:_____________________________

Birthdate: ___________/___________/_____________ (month / day / year)

E-mail:_____________________________________________________

Arrival date: _______/_______/________ 
                    (month)    (day)      (year)

[ __ ]   I would like to periodically receive email, or postal mail notification of new features,
           sweepstakes and special offers from VisitAruba.com

[ __ ]    I would like my card sent to me by mail.

[ __ ]    I would like my card delivered to my hotel.  Name of Hotel:______________________
           
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IMPORTANT: Faxed applications specifying delivery to a hotel/resort on an arrival date sooner than five (5) working days from the date of receipt of the fax order incur a short notice charge of US$2.00

In lieu of my credit card imprint, I,   _____________________________________________
                                                           (Name of Cardholder as Shown on Credit Card)

have read and understand fully, the cardmember agreement  regarding usage of the VisitAruba Plus card and agree to abide by it. I hereby authorize Carib Media Marketing & Consultancy N.V. to charge to my:

______________       _________________________   _________     __________________________
(VISA/MASTERCARD)           (Card Number)          (Exp.Date)         (Card Holder's signature)

the amount of US$13.95  being payment for the VisitAruba Plus 2008 membership period December 1, 2007 until December 1, 2008, PLUS US$3.95 (for shipping & handling to the USA or CANADA) OR US$4.95 (for shipping & handling to the REST OF THE WORLD) OR US$3.95 (for delivery to my hotel/resort), PLUS  US$ ______ for a short notice order. The total amount to be charged to my card is US$_______

TERMS & CONDITIONS: This form signifies acceptance of charges specified in writing by the cardholder  and that will be billed to the cardholder. We accept credit card orders only (Visa, Mastercard). Faxed identification is required  in the form of  Passport or Driver's License of Cardholder. Incomplete or false information shall be considered sufficient cause for denial of services. WE CANNOT ACCEPT PERSONAL/BANKER'S CHECKS - CREDIT CARD ONLY. THANKS!